The humanitarian fallout from Libya’s newest war

The Libyan capital of Tripoli is shuddering under an offensive by forces loyal to strongman Khalifa Haftar, with the city's already precarious basic services in danger of breaking down completely and aid agencies struggling to cope with a growing emergency.

In the worst and most sustained fighting the country has seen since the 2011 uprising that ousted Muammar Gaddafi, the Haftar-led Libyan National Army, or LNA, surged into the city � controlled by the UN-backed Government of National Accord, or GNA � on 4 April.

Fighting continues across a string of southern suburbs, with airstrikes and rocket and artillery fire from both sides hammering front lines and civilians alike.

It is terrible; they use big guns at night, the children can't sleep, said one resident of the capital, who declined to give her name for publication. The shots land everywhere.

The violence has displaced thousands of people and trapped hundreds of migrants and refugees in detention centres. Some analysts also think it has wrecked years of diplomacy, including attempts by the UN to try to build political consensus in Libya, where various militias support the two major rivals for power: the Tripoli-based GNA and the Haftar-backed House of Representatives, based in the eastern city of Tobruk.

"Detained migrants and refugees, including women and children, are particularly vulnerable."

Pandora's box has been opened, said Jalel Harchaoui, a research fellow at Clingendael Institute think tank in The Hague. The military operation [to capture Tripoli] has inflicted irreversible damage upon a modus vivendi and a large set of political dialogues that has required four years of diplomatic work.

Civilians in the line of fire

Media reports and eyewitnesses in the city said residents face agonising decisions about when to go out, and risk the indiscriminate fire, in search of food and other essentials from the few shops that are open.

One resident said those in Tripoli face the dilemma of whether to stay in their homes or leave, with no clear idea of what part of the city will be targeted next.

The fighting is reportedly most intense in the southern suburbs, which until two weeks ago included some of the most tranquil and luxurious homes in the city. Now these districts are a rubble-strewn battleground, made worse by the ever-changing positions of LNA forces and militias that support the GNA.

This battle comes to a city already struggling with chaos and militia violence, with residents having known little peace since the NATO-backed revolt eight years ago.

Since 2011, Libyans have faced one issue after another: shortages of cooking gas, electricity, water, lack of medicines, infrastructure in ruin and neglect, said one woman who lives in an eastern suburb of Tripoli. Little is seen at community level, where money disappears into pockets [of officials]. Hospitals are unsanitary and barely function. Education is a shambles of poor schools and stressed teachers.

Aid agencies scrambling

Only a handful of aid agencies have a presence in Tripoli, where local services are now badly stretched.

The World Health Organisation reported on 14 April that the death toll was 147 and 614 people had been wounded, cautioning that the latter figure may be higher as some overworked hospitals have stopped counting the numbers treated.

We are still working on keeping the medical supplies going, a WHO spokesperson said. We are sending out additional surgical staff to support hospitals coping with large caseloads of wounded, for example anaesthetists.

The UN's emergency coordination body, OCHA, said that 16,000 people had been forced to flee by the fighting, 2,000 on 13 April alone when fighting intensified across the front line with a series of eight airstrikes. OCHA says the past few years of conflict have left at least 823,000 people, including 248,000 children, in dire need of humanitarian assistance.

UNICEF appealed for $4.7 million to provide emergency assistance to the half a million children and their families it estimates live in and around Tripoli.

Migrants and refugees

Some of the worst off are more than 1,500 migrants trapped in a string of detention centres in the capital and nearby. The UN's refugee agency, UNHCR, said over the weekend it was trying to organise the evacuation of refugees from a migrant camp close to the front lines. We are in contact with refugees in Qaser Ben Gashir and so far they remain safe from information received, the agency said in a tweet.

At least one media report said migrants and refugees at the centre felt they had been abandoned and feared for their lives.

UNHCR estimates there are some 670,000 migrants and refugees in Libya, including more than 6,000 in detention centres.

In its appeal, UNICEF said it was alarmed by reports that some migrant detention centres have been all but abandoned, with the migrants unable to get food and water. The breakdown in the food supply line has resulted in a deterioration of the food security in detention centres, the agency said. Detained migrants and refugees, including women and children, are particularly vulnerable, especially those in detention centres located in the vicinity of the fighting.

Many migrants continue to hope to find a boat to Europe, but that task has been made harder by the EU's March decision to scale down the rescue part of Operation Sophia, its Mediterranean anti-smuggling mission.

The breakdown in the food supply line has resulted in a deterioration of the food security in detention centres.

Search-and-rescue missions run by nongovernmental organisations have had to slow down and sometimes shutter their operations as European governments refuse them permission to dock. On Monday, Malta said it would not allow the crew of a ship that had been carrying 64 people rescued off the coast of Libya to disembark on its shores. The ship was stranded for two weeks as European governments argued over what to do with the migrants, who will now be split between four countries.

Eugenio Cusumano, an international security expert specialising in migration research at Lieden University in the Netherlands, said a new surge of migrants and refugees may now be heading across the sea in a desperate attempt to escape the fighting. He said they will find few rescue craft, adding: If the situation in Libya deteriorates there will be a need for offshore patrol assets.

Failed diplomacy

Haftar's LNA says its objective is to liberate the city from militia control, while the GNA has accused its rival of war crimes and called for prosecutions.

International diplomatic efforts to end the fighting appear to have floundered. Haftar launched his offensive on the day that UN Secretary-General Antonio Guterres was visiting Tripoli � a visit designed to bolster long-delayed, UN-chaired talks with the various parties in the country, which were due to be held this week.

The UN had hoped the discussions, known as the National Conference, might pave the way for elections later this year, but they ended up being cancelled due to the upsurge in fighting.

Guterres tried to de-escalate the situation by holding emergency talks with the GNA in Tripoli and flying east to see Haftar in Benghazi. But as foreign powers reportedly line up behind different sides, his calls for a ceasefire � along with condemnation from the UN Security Council and the EU � have so far been rebuffed.